Trans Healthcare is Collapsing in Ireland

TGEU has released its 2022 Trans Health Map, outlining the current state of trans healthcare in Europe. Ireland came in last in the ranking, demonstrating how difficult access to gender-affirming healthcare is for trans people living in the country.

Access to public gender-affirming healthcare is extremely difficult and barely available in Ireland. This is significantly worse for trans and gender-diverse youth. There is only one main gender identity clinic in Ireland, the National Gender Service. While the Dublin-based clinic receives over 300 referrals per year, they are too understaffed. They do not have the capacity to see 300 people in a year. The service is only able to attend to half of those patients. Without more staff members, the waiting times will only continue to increase. As of November 2022, a new patient is forced to wait at least three to three and a half years for an initial appointment.

The service also does not offer gender-affirming surgeries. Many trans people have to go through private healthcare. If they cannot afford it, they are forced to travel outside of Ireland to get gender-affirming treatment. However, most surgeries are not provided in Ireland, neither through private nor public healthcare. Nevertheless, the National Gender Service does offer surgery referrals and can help you find a surgery clinic overseas.

National Gender Service in Ireland

The National Gender Service does not provide services to patients under 18 years old, leaving trans youth at further disadvantage. Patients aged 17 can be referred to the service, but they must be at least 18 years old before starting their treatment. In January of 2021, Ireland’s referrals to the UK Tavistock Clinic were halted. This lead to young trans people having no public access to life-saving gender-affirming healthcare services in Ireland. Throughout 2022, youth workers and organisations demanded the HSE – the healthcare system in Ireland –acknowledge the absence of gender-affirming healthcare for trans and gender diverse youth.

In July, it was also announced that the NHS Tavistock and Portman’s Gender identity Development Service (GIDS) will be closing in Spring 2023. Tavistock is the only gender identity healthcare provider for trans children and adolescents. Ireland needs to do better for trans kids.

Last year, a letter was sent to the CEO of HSE on behalf of the National Gender Service (NGS) Clinical Governance Committee. This letter expressed concerns over HSE’s trans healthcare services. It was also a request to better understand the Model of Care HSE operates under. It was found that the NGS Model of Care was created separately from the one created during the ‘broad consultation process with both professional and patient groups’.

Ireland Ranks Last

In October, Transgender Europe (TGEU) released its 2022 Trans Health Map: European Union. TGEU is a pan-European organisation focused on the well-being of trans people in Europe and Central Asia. It has a network of over 200 trans rights organisations. The map outlined the state of healthcare for trans people in Europe. Out of the 27 member states of the EU, Ireland ranked last. The map found that trans people may have to wait up to 10 years before meeting with a specialist. This is an excruciating long time for services that should be more easily available and accessible.

We spoke to Deekshitha Ganesan, the health policy officer at TGEU. She hopes that the Trans Health Map ‘can help mobilise action, that trans people in their countries can use this in their advocacy, and that authorities sit up and take notice of the situation in their respective countries’. While the ranking of the map does not encompass every trans person’s experience, it is clear that by placing last, Ireland has a long way to go regarding access to trans healthcare.

Trans and Intersex Pride Dublin told PinkNews that they are ‘not shocked’ by the results of the Trans Health Map. According to them, trans healthcare in Ireland is ‘only getting worse’. Even after the long waiting times, trans people are forced to go through a ‘dehumanising and humiliating’ process. The organisation demands that Ireland implement an informed consent Model of Care. This is the Model of Care GenderGP operates on.

‘Too Little Too Late’

The Irish Cabinet did approve a new law that criminalises hate and violence against the trans and disabled community. This bill will simplify the process of prosecutions for hate speech and hate crimes. It added gender, gender expression, gender identity, and disability under its list of ‘protected characteristics’. A person who is found guilty of inciting such violence or hate can be sentenced to five years in prison. However, activists have criticised Ireland’s new legislation as it comes ‘too little too late’.

While Ireland’s newly accepted bill helps protect the trans community in the country, it does not go far enough. Trans and Intersex Pride Dublin highlighted that Ireland is the only country in the EU ‘without any hate crime legislation’. This bill is weak in comparison to trans people’s needs.

For instance, the bill stated that ‘communication’ involving the discussion or criticism of a protected marginalised group is not considered enough for prosecution. It does not count under incitement of hate or violence. The person must have made it clear that they wanted to incite hate against a particular person due to their marginalised identity. These loopholes make it easier for anti-trans and anti-LGBTQ+ individuals to attack trans people in Ireland without facing any additional consequences. Ireland’s bill does not solve the issues trans people continue to face in the country.

More Progress is Need For Trans People

The long waiting times, the lack of staff members, and the barely accessible gender-affirming healthcare affects countless trans people in Ireland. They are forced to wait or travel abroad to afford treatment. This can increase feelings of gender dysphoria and worsen their mental health and overall well-being. It is also significantly worse for trans youth as they have NO public access to the gender-related healthcare services they need. Waiting lists need to decrease as trans people cannot be asked to wait for almost a decade before receiving life-saving trans healthcare.

There are several Irish LGBTQ+ organisations that provide mental health support and advice to trans and gender-diverse people living in Ireland. Organisations include: TENI (Trans Equality Network Ireland), BelongTo, LGBT Ireland, The Outhouse, and Gender Rebels Cork. If you need support and do not know where to go, we suggest you check out these LGBTQ+ organisations.